What is an Adjustment?

Chiropractors have one key word that they are commonly associated with, “adjustments”. But VERY few people actually know what an adjustment entails and what it does. Hopefully this changes that.

What it is not:

To talk about what an adjustment is, I think it’s a good idea to start with what it’s not. To start, the word “adjustment” is very misleading, as it makes it sound as if something needs to be physically put back into place and “adjusted”. This is not the case. Bones do not just fall in and out of place, and an adjustment is in no way geared towards “resetting” or “re-aligning” them. Secondly, an adjustment is not the cracking sound that usually accompanies it. The popping sound (called a cavitation) is just the release of gas due to pressure changes. You can get the cracking sound simply from cracking your knuckles or lying on a foam roller, but that’s clearly not the same as getting an adjustment.

What it is:

An adjustment describes a high-velocity, low-amplitude thrust performed at end-range (AKA a grade V mobilization, or manipulation). This means that the doc will apply a fast, short thrust to the end-range area he’s working on. Maybe the thrust will be accompanied by a cavitation sound, but maybe it won’t. The essence of the adjustment is the thrust, independent of the cavitation.

What it does:

Manipulations have been found to increase range-of-motion, decrease pain, and improve function for various conditions. Since the manipulation is performed at end-range it naturally exposes the body to a new range-of-motion. The high-speed thrust on the tissues will also stimulate various types of receptors in the body, including sensory and proprioceptive ones (such as muscle spindle fibers and golgi tendon organs) that heavily influence pain, muscle tone/recruitment, and body awareness.

How it does it:

It’s believed that the quick stretch the thrust provides helps relax hypertonic (tight) muscles in the area, but it’s from the receptor activation described above that a lot of the current mechanistic theories revolve around. It’s thought that certain receptors become activated that increase recruitment of core stabilization muscles (such as the transverse abdominis and multifidi) while others give feedback to the brain that helps create a “fresher” map of the body and helps form a more positive pain response.